Objective To observe the protective effect of goserelin on ovarian function of premenopausal patients with breast cancer during chemotherapy. Methods Forty patients with breast cancer under 40 received adjuvant chemotherapy were randomly divided intotest group(20 cases) and control group (20 cases). Compared the recovery rate and time of menstruation between two groups. Results All the 40 patients finished the treatment. Recovery ratio of normal ovarian function in test group and control group was 75% and 50% (P =0.013) respectively, and the median menstrual recovery time in two groups was 4.65 months and 6.65 months (P = 0.046) respectively. Statistically significant differences were found between two groups. Conclusion Goserelin can effectively protect ovarian function during chemotherapy , increase the ratio of normal ovarian function, shorten menstrual recovery time, and shows good tolerance.

Objective To explore the relationship among emotional resilience,stress and school adjustment.Methods Adolescent life events check-list,adolescent emotional resilience scale and school adjustment scale of middle school students were conducted among 394 junior high school students.Results (1)The emotional resilience score and emotion recovery score of male junior high school students(46.07±8.56,24.43±5.80) were higher than that of female ones(44.39±8.39,23.27±5.37),and the differences were statistically significant(t=1.97,2.05,P＜0.05).The total score of emotional resilience(45.46±8.50,44.83±8.56) was not statistically related with whether they were the only children(t=0.68,P=0.50).The emotional resilience score and positive emotion score of rural junior high school students(44.04±8.53,20.63±5.35)were lower than that of urban ones (46.46± 8.34,22.15 ±4.72),and the differences were statistically significant(t=-2.86,-2.99,P＜0.01).The total score of emotional resilience (47.23±7.82,44.63±8.45,43.00±8.97) in different grades was statistically significant (F=8.86,P=0.00),and the first grade students were higher than the second and third year students.(2)Psychological stress was negatively related with emotional resilience and school adjustment(r=-0.23～-0.35,P＜0.01),and emotional resilience was positively correlated with school adjustment(r=0.12 ～ 0.29,P＜0.01).The relationship between stress and school adjustment were mediated by positive emotion and emotional recovery (the mediating effect were 11.11％,21.15％).Conclusion Frotional resilience plays a mediating role between psychological stress and school adjustment.

Objective To study the clinical effect of peritoneal and abdominal indwelling tube by ultrasound for patients with severe acute pancreatitis.Methods Sixty-eight patients with severe acute pancreatitis from January 2010 to December 2013 were analyzed retrospectively.The patients were divided into experiment group (48 cases) and control group (20 cases).The patients in control group were given the common drugs treatment,and the patients in experiment group were given the common drugs and the peritoneal and abdominal indwelling tube by ultrasound.The clinical effects and complication were compared.Results The total efficacy rate in experiment group was 93.75％(45/48),in control group was 35.00％(7/20),and there was significant difference (P ＜ 0.05).Seven patients in experiment group occurred complication,after the symptomatic treatment 6 patients recovered and 1 patient died of multiple organ failure;7 patients in control group occurred complication,after the symptomatic treatment 3 patients recovered and 4 patitents died of infection recurrence.The complication rate in experiment group was 14.58％(7/48),in control group was 35.00％ (7/20),and there was significant difference (P ＜ 0.05).Conclusion Peritoneal and abdominal indwelling tube by ultrasound could improve clinical efficacy and decrease complication rate for patients with severe acute pancreatitis.

[Objective] To detect the expression levels of connexin43(Cx43),P-gp and COX-2 in bone marrow of patients with acute leukemia (AL),and investigate their relationship with the pathogenesis,prognosis and resistance of this condition.[Methods]Using SYBR green real-time quantitativereverse transcription polymerase chain reaction (SYBR-RT-PCR),the expression of Cx43,P-gp and COX-2 mRNA were detected in 77 AL patients at different phases,including 36 initially-treated,20 complete-remission (CR)and 20 relapsed.A follow-up was done in those initially lreated.[Results]Expression levels of Cx43,P-gp and COX-2 mRNA from initially-treated were 0.52±0.57,1.42 ±1.06,1.14±0.95;those from relapse AL patients were 0.20±0.40,2.29 ±1.11,1.69±0.81,respectively,those from CR patients were 0.95±0.37,0.93±-0.73,0.79±0.58,respectively,those from normal patients were 1.16 ±0.67,0.86±0.63,0.61±0.57.Expression levels of Cx43 mRNA in initially-treated and relapse AL patients were significantly lower than those in normal patients and CR patients(initially-treated P were 0.001,0.005;relapse patients were P＜0.001),while the comparison between normal patients and CR patients showed no statistical significance(P=0.185).Cx43mRNA expression level was negatively correlated with P-gp and COX-2 mRNA,and a negative correlation was noted of both two expressions in initially-treated and relapse groups (Cx43 mRNA and P-gp mRNA r were -0.471,-0.362,-0.526;Cx43 mRNA and COX-2 mRNA r were -0.479,-0.344,-0.471).A follow-up of four months was conducted in 36 initially-treated patients,eight of them died.The expression Cx43 in those who died was lower than that who survived.The difference was significant(t=2.16,P=0.042).[Conclusion] Cx43mRNA expression levels of initially-treated and relapse AL patients were lower than those in normal patients and CR patients,P-gp and COX-2 mRNA expression levels of initially-treated and relapse AL patients were higher than those in normal patients and CR patients.Cx43 expre-ssion probably is a favorable prognostic factor.Cx43 is participation in the genesis,development and drug resistance of AL.

[ ABSTRACT] AIM:To investigate the mechanism underlying breast cancer metastasis and to provide theoretical da-ta for studying the pathogenesis of breast cancer onset and development.METHODS: Human breast cancer MCF-7 cells were treated with different concentrations of furin inhibitorα1-PDX for 48 h.Wound healing assay and Transwell assay were applied to detect the migration and invasion abilities of the MCF-7 cells.The expression of cell migration-associated proteins, including membrane-type 1 matrix metalloproteinase ( MT1-MMP) , vascular endothelial growth factor ( VEGF)-C and VEGF-D, was determined by Western blotting.The protein levels of MMP2 and MMP9 in the supernatant were measured by ELISA. RESULTS:Compared with control group, 200 nmol/L of furin inhibitor exerted significant inhibitory effects on the cell mi-gration (P<0.05).The expression of cell migration-associated proteins MT1-MMP, VEGF-C and VEGF-D was significantly inhibited after treated withα1-PDX ( P<0.05 ) .Significant inhibitory effects of α1-PDX on the expression of MMP9 and MMP2 (P<0.05) in the supernatant were observed.CONCLUSION:Furin inhibitor suppresses the metastasis of MCF-7 cells via down-regulating the expression of MMPs and VEGFs.

Objective To evaluate the rules and features of the pseudoenhancement phenomenon of renal cysts during the multi-phases of contrast enhanced MSCT scan.Methods Ninety one patients with 112 simple renal cysts with B-ultrasound,CT examination,improved clinically enrolled in this retrospective study.The attenuation of the renal cysts were measured blindly in the images of CT plain scan and scans of arterial,venal and secrete phases,and the attenuation change of the cysts between pre-and post-enhanced scans were calculated; the accuracies of pseudoenhancement judging were calculated with 10 HU,15 HU and 18 HU as a threshold;the size were recorded; degree of intra renal parenchyma of the cyst were also confirmed,and so renal cysts were divided into three groups:type Ⅰ,Ⅱ and Ⅲ; The differences of attenuation among 3 enhancement phases,different size,different type were analyzed statistically with the Kruskal-wallis rank sum test,the correlation between the diameter and the pseudoenhancement in each enhancement phases were analyzed statistically with Spearman test.Results The attenuation median of the 112 cysts in plain scan,arterial,venal and secrete phase was 6.0 HU,11.0 HU,12.0 HU and 12.0 HU respectively,there was significant difference(x2=53.32,P＜0.01).The attenuation of the cysts in enhanced phases was higher than unenhanced.The range of attenuation change of the cysts between pre-and postenhanced scans was-10 to 31 HU,the number of cysts in groups of pseudoenhancement of 1 to 5 HU and 6 to 10 HU in each enhanced phase was dominant.The pseudoenhancement median of arterial,venal and secrete phase was 4.0 HU,5.0 HU and 6.0 HU respectively,There was significant difference among three groups(x2=10.062,P＜0.01).Taking 10 HU,15 HU and 18 HU as threshold for judging pseudoenhancement,the accuracy was 83.0％(239/288),95.1％(274/288) and 96.9％(279/288) respectively; Pseudoenhancement of small cysts(≤10 mm) was higher than other groups in each enhancement phase,and there was significant difference(P＜0.05).Type Ⅰ,Ⅱ and Ⅲ renal cysts were 62,23 and 27 respectively,the pseudoenhancement median of type Ⅰ renal cyst was 5.0 HU,6.0 HU and 8.0 HU respectively in arterial,venous,and excretion phase,which were higher than Type Ⅱ and Ⅲ (P＜0.05).It showed low negative correlation between pseudoenhancemen and diameter in arterial,venous and secrete phase(r =-0.326,-0.332 and-0.447,P＜ 0.01).Conclusion The pseudoenhancement correlated with the renal cyst size,the type and the enhance phases,which should be considered when making diagnosis.

County hospitals function as comerstones in China's health system,as their sustainable development plays a key role for the ongoing health reform.Disciplines are the most primary functional units of a hospital,and their disciplinary culture characteristic of the county hospital' s disciplines and fitting their current development status are definitely the most important and fundamental factor for sustainable development of the discipline.Based on extensive research,authors identified no less than eight cultural elements,namely values of life,self-confidence,a comprehensive model of talent development,safety first,teamwork,communication,scientific pursuit and health management.This study aimed at providing thoughts for the current county hospital development.

Objective To compare the curative effect of magnesium isoglycyrrhizinate and compound ammonium glycyrrhetate in patients with liver cirrhosis of decompensated.Methods Eighty-six patients with liver cirrhosis of decompensated were enrolled into the study and randomly divided into two groups: the treatment group(n=43) were given magnesium isoglycyrrhizinate once a day in addition to routine treatment;the control group(n=43) were given compound ammonium glycyrrhetate once a day in addition to routine treatment.The clinical manifestation,including symptoms,signs and hepatic function were observed.The clinical lab data,including blood routine examination,urine routine test and kidney function of all patients from two groups were collected before and after the treatments.The adverse drug reactions were monitored throughout the whole therapy.Results ALT and AST turned to normal in 97.7%(42/43) and 90.7%(39/43) of patients respectively in the treatment group,which were significantly higher than those of 72.1%(31/43) and 74.4%(32/43) respectively in the control group( x2=9.86 and 4.73,respectively,Ps＜0.05). Time to turning to normal in ALT and AST were(21.6±9.1)d and(23.1±10.6)d in the treatment group,which were significantly lower than those of(37.5±17.8)d,and(46.7±19.4)d respectively in the control group(t=5.23 and 7.01,respectively,Ps＜0.01).Conclusion The results suggested that magnesium isoglycyrrhizinate had better effect on alleviating symptoms and decreasing enzyme in treatment of liver cirrhosis of decompensated stage.

Objective To summarize the experience of tension-free repair for inguinal hernia in the preperitoneal space using modified surgical mesh. Methods From Dec 2008 to May 2010, 134 cases with 138 reducible primary inguinal hernia were randomly divided into two groups. Sixty-seven patients (70 hernias) in the study group underwent tension-free repair in the preperitoneal space by modified surgical mesh, while the control group (67 cases, 68 hernias) underwent Rutkow's herniorrhaphy by surgical mesh.Results Postoperatively 127 cases (95%) were followed up from 2 to 18 months with an average of 9. 2months[64 cases of the test group were followed up with an average of(9 ±4) months, 63 cases of the control group followed up with an average of (9 ± 5 ) months]. There was no recurrence. No significant differences were found between the two groups in the operation time (P = 0. 697), blood loss (P = 0. 318 ),hospital stay (P = 0. 116) and total postoperative complications (P = 0. 080). The visual analogue scale of the study group was lower than the scale of the control group ( P = 0. 048 ). Conclusions Modified surgical mesh is more comfortable in the treatment of inguinal hernia with tension-free repair in the preperitoneal space with a comparative result to Rutkow's herniorrhaphy by surgical mesh.